Individual provider Active NPI

Yoshihiro Miura, DPT

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1114476900
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01678600 Issued in NJ
Practice address
1250 Waters PL
Tower 1 - Suite 501
Bronx, NY 10461-2720
Phone
(718) 409-9444
NPI assigned
Sep 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01678600 NJ Primary

Addresses

Primary practice location

1250 Waters PL
Tower 1 - Suite 501
Bronx, NY 10461-2720

Mailing address

65 Virginia Ave
Dobbs Ferry, NY 10522-1915
Phone (914) 426-1632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161101000649 NY Practitioner - Physical Therapist in Private Practice 4981982675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Columbia University College of Physicians and Surgeons, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miccass Physical Therapy PCGroup PAC ID 8527100858, 10 clinicians

Practice addresses (Care Compare)

246 Columbus Ave
New York, NY 10023-3331
Phone (212) 595-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040886NYMDDentist
40QA01678600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Miccass Physical Therapy, P.C. CurrentSince Aug 28, 2023 Accepting new patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince May 1, 2019 Accepting new patients
New York Queens Medicine and Surgery, P.C. PastSince Oct 3, 2016 Accepting new patients

Locations

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

246 Columbus Ave
#C
New York, NY 10023
Phone (212) 595-4500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1114476900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 VIRGINIA AVE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221915",
            "telephone_number": "914-426-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WATERS PL",
            "address_2": "TOWER 1 - SUITE 501",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612720",
            "telephone_number": "718-409-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIURA",
        "first_name": "YOSHIHIRO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01678600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.